Cushing's Syndrome in Association with a Carcinoid Tumor of the Lung

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Abstract
A 47-yr-old man developed the symptoms and signs of Cushing's syndrome over 2 months; he had hypokalemia, marked hyperglycemia (over 1000 mg/100 ml) with profound solute diuresis and elevated levels of 17- hydroxysteroids and 17-ketosteroids in plasma and urine. After administration of metyrapone, the hyperglycemia and diuresis greatly diminished. A malignant carcinoid, which had high levels of ACTH-like activity, was then removed from the left lung and the Cushingoid manifestations disappeared. Only in a very few patients has the association of Cushing's syndrome and a bronchial carcinoid been documented heretofore. Of special interest in this case is the possibility that the profound hyperglycemia was modified by metyrapone.